<TABLE width=100% cellspacing=0 cellpadding=0>
	<TR bgcolor=black>
		<TD Colspan=2>
			<FONT color=white>&nbsp;<B>EXPENCE DECLARATION</B></font>
		</TD>
	</TR>
	<TR>
		<TD width=1 colspan=2>
			<img src="?drawimage=images/spacer.gif" width=1 height=3>
		</TD>
	<TR>
	<TR>
		<TD COLSPAN=2 bgcolor=black>
			<FONT color=white>&nbsp;Applicant Details</font>
		</TD>
	</TR>
	<TR>
		<TD width=1 colspan=2>
			<img src="?drawimage=images/spacer.gif" width=1 height=3>
		</TD>
	<TR>
	<TR>
		<TD  colspan=2>
			<TABLE width=100% bgcolor=black cellspacing=1>
				<TR bgcolor=white>
					<TD width=220 bgcolor=lightgrey>
						Applicant's Name
					</TD>
					<TD>
						<%#UserName%>
					</TD>					
				</TR>	
				<TR bgcolor=white>
					<TD  width=100 bgcolor=lightgrey>
						Application Date
					</TD>					
					<TD>
						<%#ApplicationDate%>
					</TD>
				</TR>
			</TABLE>
		</TD>
	<TR>
	<TR>
		<TD width=1 colspan=2>
			<img src="?drawimage=images/spacer.gif" width=1 height=3>
		</TD>
	<TR>
	<TR>
		<TD COLSPAN=2 bgcolor=black>
			<FONT color=white>&nbsp;Declaration Details</font>
		</TD>
	</TR>
	<TR>
		<TD width=1 colspan=2>
			<img src="?drawimage=images/spacer.gif" width=1 height=3>
		</TD>
	<TR>
	<TR>
		<TD  colspan=2>
			<TABLE width=100% bgcolor=black cellspacing=1 border=0 cellpadding=5>
				<TR bgcolor=white>
					<TD bgcolor=lightgrey  align=left width=20%>
						Amount
					</TD>
					<TD  valign=top bgcolor=lightgrey align=left>
						<%#Amount%>
					</TD>
				</TR>	
				<TR bgcolor=white>
					<TD bgcolor=lightgrey align=left >
						Description
					</TD>
					<TD bgcolor=lightgrey align=left  >
						<%#Description%>
					</TD>
				</TR>				
			</TABLE>
		</TD>
	<TR>
	<TR>
		<TD width=1 colspan=2 >
			<img src="?drawimage=images/spacer.gif" width=1 height=1>
		</TD>
	<TR>
	<TR>
		<TD width=1 colspan=2 bgcolor=black>
			<img src="?drawimage=images/spacer.gif" width=1 height=1>
		</TD>
	<TR>
</TABLE>